Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty

Bozduman, Ömer; BASAT, HAKKI ÇAĞDAŞ; KÖKER, Yasin; sezgin, hicabi; GÜÇLÜ, BERK; KİRCİL, Cihan

Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty

Hakkı Çağdaş BASAT, (Ahi Evran Üniversitesi, Tıp Fakültesi, Ortopedik Cerrahi Ana Bilim Dalı, Kırşehir, Türkiye)

Berk GÜÇLÜ, (Ufuk Üniversitesi, Tıp Fakültesi, Ortopedik Cerrahi Ana Bilim Dalı, Ankara, Türkiye)

Ömer BOZDUMAN, (Afyonkarahisar Devlet Hastanesi, Ortopedik Cerrahi Kliniği, Afyonkarahisar, Türkiye)

Yasin KÖKER, (Ufuk Üniversitesi, Tıp Fakültesi, Ortopedik Cerrahi Ana Bilim Dalı, Ankara, Türkiye)

Cihan KİRCİL, (Ufuk Üniversitesi, Tıp Fakültesi, Ortopedik Cerrahi Ana Bilim Dalı, Ankara, Türkiye)

Hicabi SEZGİN (Ahi Evran Üniversitesi, Tıp Fakültesi, Ortopedik Cerrahi Ana Bilim Dalı, Kırşehir, Türkiye)

Sakarya Tıp Dergisi

1 0

Yıl: 2018 Cilt: 8 Sayı: 2 Sayfa Aralığı: 423 - 431 Metin Dili: İngilizce İndeks Tarihi: 13-03-2020

Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty

Öz:

Objective: The purpose was to evaluate the effect of combined administration of TXA on total blood loss, hidden blood loss, drain output, costeffectiveness and periprosthetic infection rate in patients undergoing unilateral primary knee arthroplasty.Sakarya Med J, 2018, 8(2):423-431 )Materials andMethodsWe enrolled fi fty-eight patients with primary gonarthrosis undergoing unilateral primary knee arthroplasty between May 2014 andDecember 2014. We compared 29 cases performed without the application of TXA to 29 cases performed with the application of TXA.Our TXA protocol consisted of three stages.Results Postoperative hemoglobin and hematocrit levels were found to be signifi cantly lower in the non-TXA group. Estimated blood loss, hiddenblood loss, and drain output were found to be higher in the non-TXA group. Transfusion rate was lower in TXA group. The blood bankcosts were found to be higher in the non-TXA group. The total direct cost was also higher in the non-TXA group. This was average 29.9$savings per case in the TXA group. No complication such as infection or thromboemboli was detected among the study groups.Conclusion Combined topical and continuous up to 24 hours intravenous administration of TXA reduced the total blood loss and decreased drainagevolume, as well as reducing hidden blood loss.Level of evidence III.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Primer Total Diz Artroplastisi İçin Traneksamik Asid Kullanımında Gizli Kan Kaybı, Enfeksiyon ve Fiyat-Fayda Oranı

Öz:

Amaç Tek tarafl ı primer total diz artroplastisi uygulanan hastalarda kombine traneksamik asid (TXA) kullanımının total kan kaybı, gizli kan kaybı, drenaj miktarı, kost efektivite ve periprostetik enfeksiyon oranı üzerine etkisini değerlendirmektir. ( Sakarya Tıp Dergisi, 2018, 8(2):423-431 ). Gereç ve Yöntem 2014 yılı Mayıs ve Aralık ayları arasında primer gonartroz tanısı ile tek tarafl ı primer total diz artroplastisi uygulanmış olan 58 hasta çalışmaya dahil edilmiştir. TXA uygulanmamış 29 hasta ile TXA uygulanmış olan 29 hasta karşılaştırılmıştır. Söz konusu TXA protokolü 3 aşamadan oluşmaktadır. Bulgular Ameliyat sonrası hemoglobin ve hematokrit seviyeleri non-TXA grubunda anlamlı olarak düşük bulundu. Gene tahmini kan kaybı, gizli kan kaybı ve drenden olan kayıp miktarı non-TXA grubunda daha yüksek bulundu. Transfüzyon oranı TXA grubunda daha düşüktü. Kan bankası masrafl arı non-TXA grubunda daha yüksek bulundu. Total masrafl ar da gene non-TXA grubunda daha yüksek idi. TXA grubunda vaka başına 29,9 USD daha az masraf söz konusu idi. Çalışma gruplarında enfeksiyon veya tromboemboli gibi komplikasyonlara rastlanmadı. Sonuç Topikal ve 24 saat sürekli intravenöz TXA’in kombine kullanımı total kan kaybı, drenaj hacminin yanı sıra gizli kan kaybı miktarını da azaltır. Kanıt düzeyi III

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	BASAT H, GÜÇLÜ B, Bozduman Ö, KÖKER Y, KİRCİL C, sezgin h (2018). Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. , 423 - 431.
Chicago	BASAT HAKKI ÇAĞDAŞ,GÜÇLÜ BERK,Bozduman Ömer,KÖKER Yasin,KİRCİL Cihan,sezgin hicabi Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. (2018): 423 - 431.
MLA	BASAT HAKKI ÇAĞDAŞ,GÜÇLÜ BERK,Bozduman Ömer,KÖKER Yasin,KİRCİL Cihan,sezgin hicabi Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. , 2018, ss.423 - 431.
AMA	BASAT H,GÜÇLÜ B,Bozduman Ö,KÖKER Y,KİRCİL C,sezgin h Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. . 2018; 423 - 431.
Vancouver	BASAT H,GÜÇLÜ B,Bozduman Ö,KÖKER Y,KİRCİL C,sezgin h Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. . 2018; 423 - 431.
IEEE	BASAT H,GÜÇLÜ B,Bozduman Ö,KÖKER Y,KİRCİL C,sezgin h "Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty." , ss.423 - 431, 2018.
ISNAD	BASAT, HAKKI ÇAĞDAŞ vd. "Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty". (2018), 423-431.

APA	BASAT H, GÜÇLÜ B, Bozduman Ö, KÖKER Y, KİRCİL C, sezgin h (2018). Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. Sakarya Tıp Dergisi, 8(2), 423 - 431.
Chicago	BASAT HAKKI ÇAĞDAŞ,GÜÇLÜ BERK,Bozduman Ömer,KÖKER Yasin,KİRCİL Cihan,sezgin hicabi Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. Sakarya Tıp Dergisi 8, no.2 (2018): 423 - 431.
MLA	BASAT HAKKI ÇAĞDAŞ,GÜÇLÜ BERK,Bozduman Ömer,KÖKER Yasin,KİRCİL Cihan,sezgin hicabi Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. Sakarya Tıp Dergisi, vol.8, no.2, 2018, ss.423 - 431.
AMA	BASAT H,GÜÇLÜ B,Bozduman Ö,KÖKER Y,KİRCİL C,sezgin h Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. Sakarya Tıp Dergisi. 2018; 8(2): 423 - 431.
Vancouver	BASAT H,GÜÇLÜ B,Bozduman Ö,KÖKER Y,KİRCİL C,sezgin h Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty. Sakarya Tıp Dergisi. 2018; 8(2): 423 - 431.
IEEE	BASAT H,GÜÇLÜ B,Bozduman Ö,KÖKER Y,KİRCİL C,sezgin h "Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty." Sakarya Tıp Dergisi, 8, ss.423 - 431, 2018.
ISNAD	BASAT, HAKKI ÇAĞDAŞ vd. "Hidden Blood Loss, Infection and Cost-Effectiveness of Tranexamic Acid Protocol in Primary Total Knee Arthroplasty". Sakarya Tıp Dergisi 8/2 (2018), 423-431.